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Identifying subgroups of persons with multimorbidity based on their needs for care and support.
- Source :
- BMC Family Practice; 12/27/2019, Vol. 20 Issue 1, p1-10, 10p, 2 Diagrams, 3 Charts
- Publication Year :
- 2019
-
Abstract
- Background: There is broad consensus that countries need to develop and implement person-centred integrated care to better meet the needs of their growing populations with multimorbidity. To develop appropriate care, it is essential to know the needs for care and support among these populations. For this purpose, we examined whether subgroups of people with multimorbidity could be distinguished based on their needs, and profiled these subgroups according to medical complexity and the availability of personal resources. Methods: Persons diagnosed with two or more somatic chronic diseases (N = 613) were selected from 38 general practices throughout the Netherlands. We conducted a cluster analysis of their scores on the RAND-36 questionnaire of health-related quality of life (QoL), to gain insight in their needs for care and support. Differences in demographics, medical characteristics and personal resources between the identified clusters were tested using analysis of variance and chi-square tests. Results: The cluster analysis revealed three subgroups: 1. a group with a relatively good QoL (48% of the sample), 2. a group with a poor physical QoL (28%), and 3. a group with a poor QoL in all domains assessed by the RAND-36 (24%). The group with a relatively good QoL had more favourable medical characteristics than the other groups, i.e., less chronic diseases, shorter illness duration, more stable course of illness, better controllable conditions, less polypharmacy. The group with a poor QoL in all domains could rely on less personal resources (education, income, social support, health literacy, self-management capabilities) than the other groups. Conclusions: Different subgroups of people with multimorbidity can be distinguished based on their needs for care and support. These needs are not only determined by demographic and medical characteristics, but also by the personal resources people have available to manage their health and care. Patient profiles combining medical complexity and personal resources could guide the development of integrated care for specific target groups of persons with multimorbidity. [ABSTRACT FROM AUTHOR]
- Subjects :
- CHRONIC disease diagnosis
ANALYSIS of variance
CHI-squared test
CLUSTER analysis (Statistics)
FAMILY medicine
INCOME
INTEGRATED health care delivery
MEDICAL needs assessment
QUALITY of life
QUESTIONNAIRES
SELF-management (Psychology)
COMORBIDITY
SOCIAL support
EDUCATIONAL attainment
HEALTH literacy
DISEASE duration
POLYPHARMACY
Subjects
Details
- Language :
- English
- ISSN :
- 14712296
- Volume :
- 20
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Family Practice
- Publication Type :
- Academic Journal
- Accession number :
- 140917360
- Full Text :
- https://doi.org/10.1186/s12875-019-1069-6